Medicaid

Federal Health Policy Update for December 19

The following is the latest health policy news from the federal government for December 13-19. Some of the language used below is taken directly from government documents. Congress Funding for the operation of the federal government will expire tomorrow, December 20, unless Congress passes a funding bill. Earlier this week, congressional leaders agreed on a continuing resolution that included a number of health care priorities, including relief from scheduled Medicaid DSH cuts, relief for Medicare physician payment cuts, extension of telehealth flexibilities, extension of the Acute Hospital Care at Home program, a number of changes in the practices of pharmacy [...]

MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met publicly last week in Washington, D.C. The following is MACPAC’s own summary of its meeting. The MACPAC December 2024 meeting began with a discussion on accountability in Medicaid managed care, which is the predominant delivery system in Medicaid. MACPAC will examine the tools the Centers for Medicare & Medicaid Services (CMS) and state Medicaid agencies use to manage managed care organizations’ (MCOs) performance and hold plans accountable to contractual obligations. Staff presented findings from MACPAC’s review of federal policy and a 40-state review of accountability tools as described in [...]

joe2024-12-17T15:23:53-05:00December 18, 2024|Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations|

Federal Health Policy Update for December 12

The following is the latest health policy news from the federal government for December 6-12. Some of the language used below is taken directly from government documents. Congress Funding the Federal Government With funding for the federal government set to expire in eight days, Congress is still negotiating the details of the next continuing resolution. Speaker Johnson has indicated that the next continuing resolution will extend until an unspecified date in March. Last week, the House majority and House minority exchanged proposals for additional items to include in the next continuing resolution and both parties listed health care extenders – [...]

joe2024-12-12T16:16:50-05:00December 12, 2024|340b, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, Federal Update, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy|

182 House Members Ask for Halt to Medicaid DSH Cut

182 members of the House of Representatives have written to House Speaker Mike Johnson and House minority leader Hakeem Jeffries to ask them to prevent a major cut in Medicaid disproportionate share hospital payments (Medicaid DSH) that is scheduled to take effect on January 1. As members of Congress negotiate how to fund the federal government when the current continuing resolution ends on December 20, the bipartisan group of legislators as urges its leaders to prevent the $8 billion cut in Medicaid DSH allocations to the states. Their letter states that Hospitals that receive Medicaid DSH funding treat the most [...]

joe2024-12-11T12:37:18-05:00December 11, 2024|Congress, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

Federal Health Policy Update for December 5

The following is the latest health policy news from the federal government for November 22 – December 5. Some of the language used below is taken directly from government documents. Congress The House has posted its session calendar for 2025. Find that calendar here. Yesterday, House Republicans made an offer to House Democrats regarding health care provisions to be included in the continuing resolution (CR) that must pass before December 20. The offer is a conversation-opener and very few details are available. Although most of the proposed policies have bipartisan support, there are some tangible policy differences, including House Democrats’ [...]

joe2024-12-05T17:14:33-05:00December 5, 2024|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Federal Update, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Pennsylvania Update|

Federal Health Policy Update for November 21

The following is the latest health policy news from the federal government for November 15-21. Some of the language used below is taken directly from government documents. The Incoming Administration President Trump has nominated Robert F. Kennedy, Jr. for Secretary of Health and Human Services and Dr. Mehmet Oz for Administrator of the Centers for Medicare & Medicaid Services (CMS). Both positions require confirmation by the Senate. Senators will start the process of confirming the President-elect’s cabinet nominees when the new Congress convenes in January. Congress Funding for the federal government will expire on December 20 and it is still [...]

joe2024-11-21T15:14:52-05:00November 21, 2024|Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Medicaid Changes on the Agenda?

With a new administration 60 days from taking office and the same party to be controlling the White House, Senate, and House of Representatives, Medicaid changes are a common topic of conversation in Washington policy circles these days. One of the objectives of those conversations: reducing federal spending on Medicaid, which in federal fiscal year 2023 amounted to $860 billion. Among the means of reducing those expenditures that can be expected to be the subject of policy deliberations in the coming months are: Instituting Medicaid work requirements. Ending the supplemental federal Medicaid funding states receive for Medicaid enrollees covered under [...]

joe2024-11-19T16:26:24-05:00November 21, 2024|Affordable Care Act, Medicaid|

Federal Health Policy Update for November 14

The following is the latest health policy news from the federal government for November 8-14. Some of the language used below is taken directly from government documents. Election Update House of Representatives Though the outcome of nine races for seats in the House remains undecided, Republicans have won enough seats to control the House in the new Congress. Yesterday, Republicans voted to nominate the current Speaker of the House, Mike Johnson (LA), for Speaker in the new Congress and will hold the vote for that position when the 119th Congress convenes in Washington, D.C. on January 3. It is expected, after [...]

joe2024-11-14T15:18:02-05:00November 14, 2024|ACO, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, hospitals, Medicaid, Medicaid DSH, Medicaid DSH allotments, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for November 7

The following is the latest health policy news from the federal government for November 1-7. Some of the language used below is taken directly from government documents. Medicare Payment Regulations Late last week CMS published four regulations describing how Medicare will pay certain providers in 2025. The following is a brief overview of those regulations. Medicare Outpatient Prospective Payment System Rate increase of 2.9 percent for outpatient and ambulatory surgical center services. New Conditions of Participation for obstetrical services. Additional payments for selected non-opioid treatments for pain relief. Minor modifications of the inpatient-only list. A change in the review time [...]

joe2024-11-07T16:26:47-05:00November 7, 2024|Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for October 31

The following is the latest health policy news from the federal government for October 25-31. Some of the language used below is taken directly from government documents. The White House The White House has announced a new private sector pilot program to maintain uninterrupted access to seven pre-selected pediatric cancer medications. Pilot participants in this program, which is part of the Biden Cancer Moonshot, will develop stewardship standards focused on identifying shortage risks, promoting transparent inventory awareness, and fostering an effective approach to preventing patient care disruptions and maintaining consistent drug distribution to children and families facing cancer. The pilot [...]

joe2024-10-31T15:10:55-04:00October 31, 2024|Accountable Care Organization, ACO, Alternative payment models, Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations, Medicare regulations, Medicare reimbursement policy, Telehealth|